Outcome of T Tube Ileostomy with N Acetyl Cysteine Irrigation For The Management of Uncomplicated Meconium Ileus
Md. Samiul Hasan1, M Kabirul Islam2, Ayub Ali3, Sabbir Karim3
Background: Meconium ileus is a common cause of neonatal intestinal obstruction. Various
surgical procedures are in practice for uncomplicated meconium ileus. T tube ileostomy
seems to offer important advantages over surgical techniques previously described.
Objective: Objective of this prospective interventional study was to evaluate the
outcome of T-tube ileostomy for the treatment of uncomplicated meconium ileus.
Methods: It was a prospective interventional study, held in department of surgery,
Dhaka Shishu (Children) Hospital from January 2015 to December 2016. Total 21
neonates were included after fulfilling selection criteria. After T tube ileostomy all
patients were followed up for 6 weeks post-operatively. Data were collected in a
predesigned, semi structured questionnaire and outcome of all patients were noted.
Result: The age range of the patients was 1 to 6 days where majority were male.
Mean operation time was 60.76±5.81 minutes. After operation, mean time of bowel
movement, establishing oral feeding and tube removal was 4.90±1.41days, 6.35±1.27
days and 8.10±1.45 days respectively. One neonate had intraperitoneal leakage and
died of sepsis. Mean hospital stay was 9.45 1.31 days. Stomas closed spontaneously
in all survived neonates.
Conclusion: T-tube ileostomy with N acetyl cysteine irrigation is a safe and effective
procedure for uncomplicated meconium ileus.
Key Words: Meconium ileus, T-tube ileostomy.